House debates

Monday, 18 June 2007

Aged Care Amendment (Residential Care) Bill 2007

Second Reading

Debate resumed from 29 March, on motion by Mr Pyne:

That this bill be now read a second time.

7:41 pm

Photo of Russell BroadbentRussell Broadbent (McMillan, Liberal Party) Share this | | Hansard source

This bill demonstrates the government’s continuing commitment to aged-care reform and investment. It substantially increases outlays on residential care by the very significant growth in care places and its recognition of the complex care needs of residents of aged-care facilities. The bill proposes to amend the Aged Care Act 1997 to implement the government’s decision to reduce the number of funding levels in residential aged care and provide supplements for residents with complex healthcare needs, including palliative care, and for residents who have mental or behavioural conditions, including dementia.

Since coming to office in 1996, the Howard government has worked consistently to ensure that older Australians needing long-term care have access to a high-quality and affordable aged-care system capable of meeting their needs and preferences. This has included commissioning the Hogan review to look at pricing arrangements in residential aged care. The government immediately addressed the main recommendations raised in Professor Warren Hogan’s report by providing $2.2 billion as part of its 2004-05 budget package Investing in Australia’s Aged Care: More Places, Better Care—the largest single investment in aged care by any Australian government.

The new Minister for Ageing, the member for Sturt—and I take this opportunity to congratulate the minister on the work that he is doing at the present time—in his second reading speech said:

Over the last two years, the Howard government has consulted and worked with the residential aged-care industry, including nursing and care staff, to develop a more effective assessment and funding instrument which will reduce administrative effort and costs for aged-care providers—

an issue that has been raised with local members throughout the nation. Through the amendments proposed today the bill aims to replace the resident classification scale, which is the current method used to classify residents in order to allocate Australian government subsidies, with a new Aged Care Funding Instrument as the method for allocating subsidy to approved providers of residential aged care. As the minister said, the ACFI has been designed to better target funding towards the care of residents with higher needs and reduce the volume of documentation completed in residential aged-care facilities solely for funding purposes. The total investment by the government for the care of older Australians between 1996 and 2008 is $67 billion.

On 12 March this year, as a further demonstration of this government’s continued strong commitment to fair and affordable access to high-quality aged care, the Prime Minister announced an additional $1.5 billion in funding for aged-care services through the Securing the Future of Aged Care for Australians package. The Prime Minister said:

Let me put this in context, the simple fact is that over the next 20 years, as the baby boomers, as they’re called, go into retirement, we will see the number of people over the age of 70 double ... It’s a good thing. We’re all living longer, we’re all living healthier, longer lives and that is to be encouraged and appreciated. But it does of course mean that we need to put additional resources ...

This bill and this package will address these challenges. They will ensure that an increasing number of older Australians now and in the future will be able to access the right level of care when they need it. It will also help Australia’s aged care centre to meet those needs. The Howard government is providing more and better community care so more people can continue to live in their own homes for longer; increasing investment in high-level residential care; better matching funding to care so that, over time, payments for those with the highest care needs will increase; introducing a new, fairer income-tested care fee, which will no longer treat self-funded retirees on a different basis to pensioners with a similar income; providing more help for disadvantaged older people and people in remote areas, including Aboriginals, Torres Strait Islanders and homeless people; and introducing other measures to improve the fairness of the aged-care system.

These changes will make a fairer, simpler and better system, and will involve a large increase in Australian government subsidies for aged care. This bill and this package are further recognition that our aged-care system faces a number of long-term challenges. By 2051, Australia’s population is expected to reach 28 million, an increase of 37 per cent from today. Over the same time, the number of people over 55 is expected to increase by 113 per cent, from five million to around 10.7 million. The change will be even more marked among people aged 85 or over. At present this group represent around 1.4 per cent of the population. By 2051, they will account for between six per cent and nine per cent. These are massive changes and they present a number of challenges, but this government is facing up to these challenges. Our initiatives to date include: workplace and superannuation reforms, an overhaul of aged care, strengthening Medicare and the Pharmaceutical Benefits Scheme and increases in the training of doctors, nurses and aged care workers.

Of course, the Treasurer had to give my friends on the opposite side of the House a little money lesson this week with regard to saving and preparing for these challenges. The Future Fund, the Treasurer said:

... should never be funded by taking away the savings of future generations. Let me tell you, if you take the money out of the Future Fund now, you spend it, you are still going to have $140 billion of liability in 2020 except you won’t have the money to pay them.  And just at a time when the population is ageing, when we have got fewer people in the workforce, when the demands are greater, you are going to have no provision or less provision to actually meet those liabilities.

On this side of the House, we recognise the need to save and invest in the future generations of this nation and the challenges of an ageing population; the Labor members opposite want to raid the kitty and spend the proceeds now. It is what Labor did when they were in office 11 years ago. Labor cannot be trusted with money. They see this fund, which has been set aside to set up Australia for future challenges, as something they can break into and they are trying to consume the proceeds for their own electoral purposes.

My electorate of McMillan is a snapshot of the ageing population picture. The McMillan electorate covers some 8,300 square kilometres, from the Great Dividing Range, or Mount Baw Baw, in the north to Wilsons Promontory in the south and from the eastern outskirts of Melbourne, at Pakenham, to the heart of the Latrobe Valley in the east. 15.4 per cent of the population is in the 65-years-and-over age bracket. That is higher than the average for Victorian rural electorates. Within McMillan itself, the figure varies widely. The highest proportion of the 65-plus age group is in the south Gippsland region, where the proportion is over 16 per cent. McMillan has 24 aged-care services. Today, that is 1,227 beds. In 1996, it was a mere 776 beds, when the Howard government came to office.

Of course, every member in this House would boast of the facilities in their electorate. I also boast of the facilities in my electorate of McMillan. I recently visited Rose Lodge in Wonthaggi, who were successful recipients in the 2006 aged-care funding round of a further 20 low-care beds. This will further enhance the good work being done at Rose Lodge, particularly the work of Barbara Shipp, secretary of the board, and Mrs Clara Purcell, who plays piano. She sings and plays some of my dad’s favourite songs, particularly Dancing with My Shadow, which she knew. I am very proud of the aged-care facilities in my electorate. I do not think the minister at the table would know that song, but I am sure his father would.

Photo of Greg HuntGreg Hunt (Flinders, Liberal Party, Parliamentary Secretary to the Minister for Foreign Affairs) Share this | | Hansard source


Photo of Russell BroadbentRussell Broadbent (McMillan, Liberal Party) Share this | | Hansard source

I am a supporter of continued investment in aged care across the nation, but in particular I am seeking to support, as I always do, individual centres. I mention three aged care facilities in my electorate: Lyrebird Village in Drouin, Latrobe Valley Village in Moe and the Corner Inlet Community Care Association’s nursing home at Toora and associated facilities. I will just dwell on the Corner Inlet Community Care Association for a minute. It is a community owned, not-for-profit association operating in surplus. They operate two nursing homes—Banksia Lodge Hostel at Foster and Toora Nursing Home at Toora, where I visited recently, and I am there quite often.

I have seen the work that those wonderful people do in nursing homes. It takes particular people with particular expertise and particular heart to deal with people who are not sick but old. It takes compassion, care and heartfelt endeavour. I am sure that I am not the only member in Australia who recognises the work that people do within aged-care facilities. They are dedicated and put in an effort because sometimes, not all the time, they have very difficult clients. The Toora Nursing Home is the biggest employer in Toora. Toora is only a tiny place and Toora Nursing Home is not a big nursing home. They not only meet but exceed accreditation standards in quality of care. They have a very efficient and professional board of management. Good operations always—as you know, Mr Deputy Speaker Wilkie—come from good leadership and a community that actively supports their endeavours.

I will be speaking further about these issues with the new aged-care minister—about being able to support this group and others who have done the hard yards and stood on their own as a beacon of success in that community. These people have raised a very large amount of money to support themselves in the process. I can only appreciate how much a local community cares about their aged-care facilities when they do it in real terms—when they raise real dollars, big money, as an investment. It is an investment not only in the aged-care facility, the staff and leadership but in those who have paid such a high price in the past, many of them through two wars. These people have been the great investors in the community where I live and work, in South Gippsland and across Gippsland. I have mentioned the area that I am from. We owe a great debt to that generation and, in owing that debt, it has been with some gratification that I see the money that the Howard government has poured into the aged-care sector. There is always more to do. The government, above all, knows that there is always more to do. Six years ago, the government announced the whole-of-government approach to the ageing of Australia’s population and has pursued that ever since. This bill continues on that path. I commend the bill to the House.

7:55 pm

Photo of Laurie FergusonLaurie Ferguson (Reid, Australian Labor Party, Shadow Minister for Multicultural Affairs, Urban Development and Consumer Affairs) Share this | | Hansard source

On 6 June I met with a number of organisations in Melbourne who have involvement in aged care: the Australian Greek Welfare Society, COASIT—the Italian Assistance Association—and the Australian-Polish Community Services. In the case of the Greek and Polish organisations, I have had meetings with them over the years, and it was not my first visit to COASIT. I mention in passing that one thing I was very impressed with was the amount of money the Italian government devotes each year to the retention of Italian languages in Victorian secondary schools. The Italian government actually funds 40 teachers to come to Australia each year to assist in the Victorian secondary education system. I also mention that I have had previous meetings with the Ethnic Communities Council of Victoria, the ECCV. This visit, some correspondence from those organisations and earlier activity by the ECCV will inform my comments on the Aged Care Amendment (Residential Care) Bill 2007.

This bill seeks to amend the Aged Care Act 1997, introducing a new arrangement for allocating subsidies in residential aged care: the Aged Care Funding Instrument. The bill also alters current arrangements in which classifications expire after 12 months and removes the requirement for providers to submit reappraisals, but it gives providers the option to reappraise residents after 12 months. Another area of amendment allows a provider to accept a resident’s current classification when a resident moves from one home to another rather than being required to submit a new appraisal. I would think that is an eminently sensible suggestion. In essence, the bill is designed to reduce the amount of documentation generated in aged-care facilities which is required to justify the funding classification for each resident. The opposition welcomes the stated objectives of reducing paperwork for aged-care staff and, hence, liberating people’s time for essential tasks in actually caring for residents.

With the above in mind, I now move on to the issue of providing aged-care services to people from culturally and linguistically diverse—CALD—backgrounds. This issue has been raised with me by numerous community organisations, including the Ethnic Communities Council of Victoria—ECCV—which, it must be said, of all the state organisations of the Federation of Ethnic Communities Councils, has been the most active around these issues. According to the ECCV, senior people from CALD backgrounds are rapidly ageing. It is projected that CALD seniors will represent 38 per cent of Melbourne’s senior population by 2011, based on the departments of Treasury and Finance figures in 2004. In particular, the population of CALD people aged 80-plus in Victoria is projected to grow at the exponential rate of 171 per cent between 1996 and 2011. That is based on material from the Australian Institute of Health and Welfare.

As summarised by the previous speaker—and, no doubt, it will be repeated by many other speakers in this debate—it is well known that Australia’s population is progressively ageing, as is the case in many Western nations. Approximately 13 per cent, or 2.5 million people, are currently aged over 65. By 2051 the proportion of the population aged over 65 will represent one-quarter of the nation’s population, barring major immigration intake changes. While the population as a whole is ageing, the migrant-background population is ageing even more rapidly. By 2011, just four years from now, it is predicted that nearly 23 per cent of Australians aged over 65 will be from a culturally and linguistically diverse background. The Federation of Ethnic Communities Councils argues that demographic changes within CALD communities are reflective of Australia’s migration patterns.

Refugees from eastern Europe and the Baltic states described as displaced persons began to arrive in Australia after World War II, while the 1950s and 1960s intakes were characterised particularly by nationals from Germany, Greece, Italy and the Netherlands. These participants in Australia’s postwar migration program are now representative of the growing group of older CALD persons. As at 2001, the top five oldest birthplace groups were from Italy, Greece, Germany, the Netherlands and Poland. While Italy and Greece represent the most demographically significant birthplace groups in overall numbers and will continue to dominate for the next 20 years, by 2026 people of Vietnamese and Chinese background are projected to rise to third and fourth position respectively in the top four cultural groups of the older CALD population. Naturally, the number of aged people in this group is only going to increase. With this will come more difficulties and greater urgency, and there is a need to act now.

The following national statistics provide a snapshot. As of 2001, there were 94,500 people aged over 65 who spoke Italian at home; 43,000 Greek speakers; 29,000 speakers of the total of Chinese languages; and 24,000 German speakers. If we look at some of those language groups, we notice that some of the smaller groups have a large number of their population in the over 65 age category. Amongst Ukrainian speakers, the figure was 43½ per cent. Of those who speak Netherlandic and related languages, such as Frisian, it was about 39 per cent. Of Hungarian speakers it was 32 per cent, and of German speakers it was 31 per cent.

I note in passing my disquiet at the decision of the Department of Immigration and Citizenship to discontinue funding for the Ukrainian Welfare Association in my electorate at a time when this particular community—whilst its numbers are being reduced and we are on to the third and fourth generation in some cases—is facing particular needs, especially in the aged sector.

In the lead-up to the 2006 Victorian elections, the Ethic Communities Council of Victoria prepared an insightful report into the key issues affecting ageing CALD communities in Victoria, titled A proposal for a multicultural aged care strategy. Some of its analyses involved:

Clearly communities with large ethno-specific populations should be entitled to deliver services, particularly communities such as the Italian, Greek and Polish—


have large numbers of seniors with low-level English proficiency.

That was the reality of their employment in the manufacturing sector in this country when English was not required for unskilled jobs and there was not much availability of classes at work or the time to pursue them out of hours. Another matter raised by the ECCV was:

Ethno-specific agencies and migrant resource centres are close to their communities and intimately understand and are able to respond to their communities’ needs. A Multicultural Aged Care Strategy should commit to supporting ethno-specific agencies and where relevant migrant resource centres as key partners in delivering aged care services, particularly when there is critical mass in those communities.

These issues are particularly acute for some eastern European communities. For example, the Polish community has been early to reach its peak demand for aged-care services. As a result, the Australian-Polish Community Services Inc. have recently written to me about a number of issues: the need to expand the existing Community Visitors Scheme; the lack of culturally appropriate activities for CALD residents in aged-care facilities; and the almost complete lack of use of interpreters by residential care providers—in this case, the Poles themselves raised their personal circumstances. This is particularly problematic when residents are trying to express complex medical conditions and are having them explained to them.

Another issue raised was that existing promotional materials need to better reflect the needs of communities, such as the Polish community, where failing memory amongst many has meant that they are no longer able to communicate in English. I give a personal instance of a person known to me, Larry Kowzlowski. He is formerly of Granville. He is a person who did not totally immerse himself in the Polish community. He is a follower of the Western Suburbs Tigers rugby league team and a person who frequented clubs in the area. He is married to a woman of Tongan extraction. He was involved in the Catholic Church and in broader Australia. He was a victim of the Nazis and received some compensation for that years later. This person did not live inside the Polish diaspora. He lived in the broader context of Australian society, yet he is part of the example that the Polish community has given to me in that he has totally lost his English ability and can now only speak in Polish and is in a nursing home. He is a local example of that problem.

Similarly, it is claimed that Carers Australia are not aware of the needs of ethnic carers and they are not referred to at all in their policy responses. Some of the key recommendations in the ECCV’s multicultural aged-care strategy include combining various multicultural aged-care programs with limited funding into a comprehensive multicultural aged-care strategy; allowing more client choice in selecting HACC providers; strengthening the capacity of ethno-specific agencies to provide services for larger ethnic communities; ensuring state public sector aged-care facilities provide culturally sensitive services wherever appropriate; funding ethnic senior citizens clubs—and one aspect of my recent Melbourne visit that was particularly impressive was the number of clubs in the Greek community that operate in that city and the support given by the Greek Welfare Association and its staff and volunteers to them; and, finally, ensuring that elder abuse in ethnic communities is addressed.

In respect of HACC, the ECCV has spoken of greater consideration being given to client choice in HACC services. In many areas of government service provision today, such as residential aged care, clients may choose their preferred provider. However, many HACC services seem to have been exempted from the reality of this general trend. That is particularly the case in Victoria, where there is, by national standards, a very high participation by local government in the delivery of HACC. Local government, nursing services and community health centres are the main providers of HACC services. While the Culturally Equitable Gateways Strategy and cultural action planning have strengthened local government’s commitment to multicultural services, more precise research is needed on issues such as the level of multicultural and bilingual staff in local government services and the efficacy of translated materials for HACC services.

In summary, I have taken some time to speak about the specifics of a burgeoning problem in respect of the ageing of our postwar migration intake. It is all right to assume that families are close in these communities. Traditionally, they have not been as prone to recourse to aged-care facilities. But whether it is from the point of view of them living independently or the reality of modern Australia, the second and third generations of these communities are as subject to social change as the rest of society, and it cannot be assumed, as it was in the past, that these issues will be taken care of in the family context. We have to face up to the failures in the system that are there at the moment because the community was perhaps not attuned to the expanding numbers, to the changes that are occurring inside these demographics themselves. These organisations, particularly in Victoria but also in other states, have been proactive in trying to get some attention focused towards these issues.

8:07 pm

Photo of David FawcettDavid Fawcett (Wakefield, Liberal Party) Share this | | Hansard source

I rise tonight to speak to the Aged Care Amendment (Residential Care) Bill 2007. The purpose of this bill is to amend the Aged Care Act 1997 to introduce a new arrangement for allocating subsidy in residential aged care. Specifically it is to replace the resident classification scale with the Aged Care Funding Instrument as a means of allocating subsidy to providers of residential aged care.

The key point about this is trying to make the system more efficient. It is going to reduce the number of funding levels in residential aged care and provide subsidies for the care of residents with complex health and nursing needs, including palliative care and care for residents who have mental or behavioural conditions, such as dementia. It is designed to reduce the amount of documentation and record keeping which staff have to generate in order to justify the funding classification for each of their residents.

The bill also changes current arrangements in which classifications expire after 12 months. It allows the option for managers and operators of residential facilities to renew a classification at 12 months if they want to, but, by removing the requirement to reclassify at the end of 12 months, there will be some 60,000 classifications a year that will be not required, and that in itself will provide a substantial saving to the sector. The bill also allows the secretary to define the types and forms of records that an approved provider must maintain. This will reduce the amount of documentation and record keeping needed to justify the funding. It will also streamline the audit process so that single questions or specific groups of questions can be targeted by the review officers, rather than every single aspect of the appraisal.

The last significant point is that the amendments allow an approved provider to choose to accept a resident’s current classification if a resident moves from one home to another, rather than being required to submit a new appraisal. This has come not so much out of this place but out of a two-year consultation throughout the sector, with providers and, importantly, with their staff—both nursing care staff and administrative staff—to work out the most efficient way to manage the governance surrounding the funding that the Australian government provides, along with practical and effective record keeping and care for residents.

In 2005 there was a trial in which nearly a quarter of all residential facilities in Australia participated, and they found some significant developments through that. This does not come for free, though. There are costs that will be involved with this. These costs will ensure that the level of funding for existing residents will not decrease when they are reassessed under the new Aged Care Funding Instrument. It will provide additional funding for the top levels of the two new supplements, and it will establish a panel of advisers to assist homes to manage the transition—in all, some $393.6 million.

Why is the government making that investment in the system? I think most people in Australia now are aware of the fact that, with the ageing of our population, the number of Australians aged 70 or older is expected to double in the next 20 years. That is going to place a huge demand on our aged-care system, both the residential system and the provisions we make for people to stay at home. That means that we need to invest now, to commit funds now, to make running the system by which we manage aged care as efficient as we possibly can and providing that care for the people who need it as effective as we possibly can.

It is worth pointing out that the reason this government has been able to make this investment, as well as the significant investment of $1.7 billion in aged care in the budget this year, is its good economic management. Having paid down the $96 billion of Labor debt that we inherited in 1996, we now have some $8½ billion of saved interest payments that is providing a dividend to a range of areas, such as education, defence and aged care.

The budget measures this year include the extensive package of reforms called ‘Securing the future of aged care for Australians’. The budget allocated some $1.1 billion to increase government payments for residents of aged care. Overall funding will increase by some $1.3 billion over the next four years, on top of increases for indexation. That includes some $92.2 million in the form of a transitional accommodation subsidy to offset the changes that we are discussing in this bill.

As I have said, the number of people over 70 is going to double in the next 20 years. That means we also need to be looking for innovative ways to care for people who are ageing and need assistance. That does not mean that we need to be building more homes necessarily, because, increasingly, people are indicating that, where possible, they would rather stay in their own home—or perhaps downsize to a smaller home, but certainly stay in their own community and have that support from family and friends and a familiar environment. So the government, as part of this budget, has increased the availability of aged care in people’s own homes, at the cost of some $411 million.

An additional 7,200 community care places are going to be funded over the next four years, and these places will take our aged-care ratio from the current target of 108 places per thousand people who are aged 70 and over to a record 113 places per thousand people by 2011. This compares with around 93 places per thousand when the government was elected in 1996. In 1996 there were fewer than 5,000 Community Aged Care Packages, and now there are over 40,000. Community care has extended to the provision of high-level care at home. This is significant, particularly for people who are living in regional areas, where the cost of maintaining a residential facility, without the benefits of the economies of scale, is a significant issue for communities.

In South Australia, a range of packages have been made available in this current round and out to 2009-10, and they are going to a fair range of places. Within Wakefield, there are facilities ranging from the very large, such as Domus Operosa, at Burton—which is run by the Italian village and is a magnificent facility—and Resthaven, through to country homes such as Wheatfields, in Freeling, and Indigenous specific homes such as the Aboriginal Elders Village. There is also Mill Court, in Balaclava; the Gilbert Valley Senior Citizens Home, in Riverton; Hamley Bridge, in the Memorial Hospital; and the community hospital in Mallala provides an aged-care facility. A number of these are very small facilities and at least a few are run by the community.

One of the challenges that Australia faces into the future is how we support these communities. I am thinking particularly of the communities in Riverton, Mallala and Hamley Bridge, with whom I have had extensive discussions around the viability of the aged-care homes. In Mallala, for example, the aged-care facility there—Butlers View—is the largest employer in the town. It is also the facility where many people in the community choose to live when they can no longer live in their own home. But the facility is up against it in terms of actually making ends meet. I think that one of the next phases that Australia needs to look at in terms of how we fund aged care is not only how we work with the mainstream in metropolitan areas or large regional areas but also, when it comes to smaller rural communities, how we get alongside these facilities, how we have a funding model that meets their needs so that these facilities can maintain not only the employment but also the focus of families.

One of the options that we have been exploring in Wakefield is how communities can optimise the facilities they have in terms of the building and particularly the staffing to expand the provision of in-home care. I welcome the fact that there are a number of Community Aged Care Packages and the Extended Aged Care at Home packages that have been allocated to South Australia. That is one avenue that I believe we need to explore more assertively in our rural and regional areas, along with appropriate levels of training, so that we can provide care for people who choose to remain in their homes in our regional towns. I welcome the initiative that the budget brings, and I welcome the efficiencies that this new funding formula and method of funding brings to the aged-care sector. I certainly think we owe it to our communities, and we owe it to those who have gone before us to provide appropriate care for them. I commend this bill to the House.

8:17 pm

Photo of Dick AdamsDick Adams (Lyons, Australian Labor Party) Share this | | Hansard source

The Aged Care Amendment (Residential Care) Bill 2007 was introduced into the House on 21 March this year. The Senate, on the recommendation of the Selection of Bills Committee, referred it to the Senate Standing Committee on Community Affairs. That committee reported on 17 May and made several recommendations. Labor believe that those recommendations should bring in some amendments to this bill, such as the omission of item 27, which repeals subsection 42-1(4) of the Aged Care Act 1997, and that the Department of Health and Ageing monitor the use of this subsection by aged-care facilities to ensure that it is used appropriately. We have major concerns with that item.

The bill repeals a provision entitled ‘high-dependency care leave’, which allowed more than one residential care subsidy when a resident has to move to another service temporarily—usually to a high-care facility. This provision existed under the resident classification scale—the RCS. Both the submitters and the department acknowledged that it is a little-used provision with fewer than 20 applications a year. The department’s evidence to the Senate committee also suggested that some applications on review may have been inappropriate. However, for a few small, often rural, facilities, the removal of the high-dependency care leave provision may have a significant financial impact, resulting in the potential for residents not being able to return. For this reason, Labor will move in the future to reinstate high-dependency care leave.

The Senate community affairs committee also recommended that the bill be amended to ensure that determinations made by the minister under items 28, 29 and 31 are reasonable and that a safeguard similar to that in section 44-4, which item 32 repeals, be implemented under the ACFI to determine a minimum lower basic subsidy level. In the move from the RCS to the ACFI, the provision to downgrade the basic subsidy by two levels cannot be transferred, due to the changed funding methodology. The bill proposes that the minister can determine the lower basic subsidy when a resident is receiving extensive care in hospital. The residential aged-care sector is nervous that the determination could result in a significant loss of funds. Labor is concerned that the minister may determine a reasonable level of reduced subsidy. The community affairs committee recommended that a review of the new Aged Care Funding Instrument be undertaken 18 months after implementation to assess the implications to all aged-care service providers and ensure that stated benefits are achieved. Labor will look for a formal review within 18 months of implementation of these provisions.

Despite this bill’s attempts to address a more flexible funding regime, there are big problems in the aged-care sector in my home state of Tasmania, and this bill gives me an opportunity to speak a little more broadly on the issues the bill is attempting to address. We have many aged and frail languishing in public hospital beds, causing blockages in the public health system. Funding for the aged-care facilities in many areas of my electorate of Lyons continues to fall, leaving many families with few, if any, options for the care of an elderly relative and, therefore, restricting access to nursing homes that would normally be glad to take them.

Some 3,000 nursing homes across Australia are at this time catering for over 160,000 people, with the demand for care increasing dramatically. It has been estimated that by 2019 there will be a need to provide care for some 970,000 people. This is a factor that the Howard government continues to refuse to recognise. Where do they think these people will be placed? They cannot stay at home, as the funding for home based care is insufficient to allow that to continue safely. Home based care programs are continually suffering from a severe lack of funding and an inability to get quality staff to carry out the care—though many people would rather stay at home under that sort of care. In many cases, families cannot care for their elderly parents or relatives because of other commitments on their time—for example, work and caring for children or a partner. What happened to the promise in 1997, when the Howard government made some pretty significant changes to the aged-care system which it predicted would guarantee positive outcomes for elderly Australians? Those changes never happened. The reforms never actually came into being, leaving a very large sector of the community still waiting to hear how their loved ones could be cared for.

Recurrent funding of aged care is high on the agenda for all providers. Maybe it is time to move to a funding model based on an accommodation component and a care component. It is suggested that there should be separation of these two cost drivers in residential aged care. This could possibly offer the public more flexibility, transparency and community understanding in this service delivery area.

One of the most difficult problems for providers is bed allocation. The application process is yet another failure of the Howard Liberal government. I have been approached on many occasions by providers seeking assistance with their applications. When I have asked the government for information and clarification of the issue, I have always been told that it is commercial-in-confidence or has to do with privacy. It is a competitive process, and it will probably stay that way. In many cases, it has cost providers a lot of money to put together an application. The money spent on the application process would, I am sure, have been better used if allocated to the operations of the residential care facility.

Planning for the care of the elderly appears to be an area of mystery and intrigue. On questioning about planning ratios, the response has always been, ‘That’s the way it was, so we just put it into place more formally.’ With an ever-changing demographic, along with improvements in the health status of older Australians, this area requires far more robust analysis. Aged care requires a well-trained and compassionate workforce. Over the past 10 years the shortage of nurses has become a significant issue, and this must be dealt with as quickly as possible. The number of nurses working in residential care has declined considerably while, at the same time, the community is calling for a diverse set of workers to respond to the individual needs of older people wherever they are living.

There are myths and incorrect assumptions about working in aged care. The allocation of additional undergraduate nursing places in the budget is of course welcome, but it is now our responsibility to ensure the recruitment of more nurses for the aged-care sector. There needs to be more encouragement of personal carers to adopt careers in aged care. The involvement of the medical and allied health professions in aged care is a goal that we all seem to want to achieve, but the barriers remain. There are access, funding and availability questions that must be addressed. Pay equity is an issue relative to not only nurses but also all aged-care workers. This should be addressed immediately. The conditional adjustment payment to 2007 is not of itself a sustainable solution.

Community expectations are growing very quickly. Families of residents of aged-care facilities and receivers of community care increasingly want to understand the type of care being provided. There will increasingly be an expectation that the staffing level and mix be known and understood by families of people who receive care.

Workforce issues present a challenge that can only be achieved through government and sectoral collaboration around funding, consumer education, training and education, career path development and national leadership. Labor will continue to hold the Howard government accountable for its failure to plan ahead and provide the type of detailed policies that are needed in aged care in particular. Planning for our built communities needs to take into account the overall ageing of the population. This needs to be kept in mind, with clever design and innovative ideas. This brings challenges to the building industry, town planners and governments, particularly local government, in delivering homes and communities that are suitable for the needs of an ageing population.

Some people are likely to choose lifestyle villages, whereas others may choose to stay in their own homes that have been modified with, for example, wider doorways and ramps, and some may need greater care. For those who choose to stay in their homes, there is the significant issue of social isolation. It is here that policy needs to be developed to prevent this isolation from becoming an epidemic in Australia. This isolation often develops because the person may have a disability or may have lost a partner or may have few transport options. Planning must take all of these circumstances into consideration in order to achieve cohesive communities. The importance of older Australians remaining involved in community life and remaining socially connected cannot be underestimated in their maintaining good health, both physically and mentally.

8:30 pm

Photo of Bruce BairdBruce Baird (Cook, Liberal Party) Share this | | Hansard source

I rise in support of the Aged Care Amendment (Residential Care) Bill 2007. This bill demonstrates the commitment of this government to aged care in Australia. There is no question that Australia’s aged-care system faces a number of long-term challenges, with the number of Australians aged 70 or over expected to double in the next 20 years. In response to this increase, the federal government has made and is continuing to make the largest ever investment in this essential area. In my electorate of Cook, in the Sutherland shire of Sydney, approximately 21 per cent of the population is aged 65 or over. I am part of that demographic. I would point out that this percentage is very high, even by Australian standards. When you compare this to the national average of around 13 per cent, you can see why a secure aged-care system is of such importance to my constituents.

Just in the last six months, I have had my own experience with the aged-care system through putting my mother-in-law into aged care. I have found out about the challenges that exist. That is one particular reason why I support the bill. Classification delays the move of people from hospitals into aged care. In the case of my mother-in-law, she lay in a hospital bed for six weeks awaiting classification. This was a hospital bed that could have been used by others. This slowness in the classification of older people’s needs is holding the system back and delaying them entering aged-care facilities. For those who have not experienced the placing of a loved one into aged care, it is full of challenge and heartbreaking in many ways. That makes it all the more important to look at the aspects of this bill.

I was extremely pleased to see in the recent federal budget that this government has delivered even further assistance to older Australians. The most notable investment has been the $1.5 billion securing aged care package, which will help older Australians stay in their own homes as well as further assist our aged-care facilities. This record investment is having a profound impact on the quality and availability of aged care in the Sutherland shire. As you can guess by the demographics that exist in my electorate, whether one has the ability to stay in one’s home is an oft asked question. In the last financial year, two aged-care providers in my electorate received funding for a total of 44 residential places worth an estimated $1.6 million. Amenity, in Sutherland, and Juliana Village, in Miranda, received the funding for these 44 places, with 32 of them being for high care and 12 for low care. Fifteen places have been particularly reserved for war veterans and another 20 for dementia patients.

I have regular community consultations on Saturday mornings. I write to people in the area and ask them to come up and see me if they have issues. Finding beds for parents with dementia must rank in the top five issues that people raise with me, so I am very pleased that these additional dementia care beds have been made available. There is also provision in this funding for six places for people of a non-English-speaking background. While that is very welcome, I will point out that 93 per cent of my electorate is Anglo-Celtic in background.

The Australian government is committed to delivering world-class aged care in the Sutherland shire. I was recently able to attend the opening of the Woolooware Shores aged-care complex, a real five-star complex. This is a new complex servicing the shire. The government is funding 119 low-care residential places there. These places in Cook form part of a national allocation of $208 million and 7,815 places for residential and community aged-care places to be funded by the Commonwealth this year. I am sure that with this kind of investment residential places will continue to increase as further funding rounds are announced. Aged care is a major concern for seniors and their families in my electorate and these funding boosts certainly provide them with some peace of mind for their future.

Because of this government’s strong economic management, the 2007-08 budget was able to deliver even further assistance to older Australians. My electorate office has received a lot of enquiries from pensioners who will now quality for one-off bonus payments of $500 for individuals and $1,000 for couples. This financial assistance will alleviate some of the costs associated with staying at home and running a household on the pension. While this kind of payment may help those in immediate need of financial assistance, the government recognises that it is important to also invest in medical research for the future. We are continuing our strong support for carers. For those who are receiving the carer allowance, we are providing a one-off bonus payment of $600. This is the fourth successive year we have paid the bonus to carer allowance recipients. Also, in July this year, the veterans’ special rate disability pension will increase by $50 a fortnight. The government will also make one-off payments of $25,000 to Australians who were prisoners of war in Europe. I have a large number of returned soldiers from the war in Europe in my electorate, so that will be received very well. These measures were all announced in the recent federal budget.

While we are intent on securing the future of Australia’s aged through these provisions, we are also looking at ways in which our existing system may be improved. The bill before the House represents our commitment to ensure that all Australians benefit from a secure, fair and accessible aged-care system. It is about looking at the way our system functions and making the necessary changes to ensure aged care is better targeted towards the needs of seniors and is not held back by unnecessary components which simply tie up the time of those working within the aged-care sector.

In 2004, following the recommendations of the Hogan report, this government announced it would review Australia’s funding arrangements for the delivery of aged care. Through these amendments this bill aims to replace the existing Resident Classification Scale, or RCS, with the improved Aged Care Funding Instrument or ACFI. The ACFI will improve the delivery of aged-care services through better targeting of funding towards the care of residents with higher needs. It will also reduce the amount of documentation and paperwork completed in residential aged-care facilities solely for funding purposes.

With the current challenges facing our aged-care system the last thing we could afford to do is allow it to become bogged down in unnecessary administration. These unnecessary costs are evident in our reappraisal system as they currently stand. Under current conditions a resident’s classification for funding will expire after 12 months, and after this time a reappraisal will be required. Aged-care providers say this unnecessarily ties down the administrators of the aged-care facilities and prevents them from doing other things, and, of course, they never know quite where they are going with the funding that is likely to occur. Last year 60,000 reappraisals were processed with no change in the funding amounts—that says it all. If you do not change it, why bother to go through it every 12 months? This means that 60,000 forms were filled out and processed by providers and staff working within our aged-care system. There is no doubt that we are much better off having these people involved in providing facilities for our older Australians rather than in completing forms.

To eliminate the need for unnecessary reappraisals, a standard ACFI classification will not expire. Instead, providers will be given the option to reappraise a resident after a 12-month period. In addition to this, residents entering aged-care facilities straight from hospital will be reappraised after six months. This is in recognition of the fact that their needs may change more quickly than other residents. It is a much more sensible system that will save time and will better target funding towards the care of residents with higher needs. The bill will also limit the amount of unnecessary administration by allowing residents to relocate from one residential facility without the need for reappraisal. Last year 12,000 residents moved from one aged-care home to another. Under current conditions, when a resident makes this move their funding classification will expire. It makes sense that under these arrangements the classification will continue.

Another way we can improve the performance of our current system is by removing any unnecessary components which may become obsolete. This can be said about the current provision which allows more than one aged-care home to be paid a subsidy for the same resident when a person is on high-dependency care leave. Now that the age-in-place provisions allow residents to move from low care to high care within the same home, this subsidy is very rarely used. This bill proposes that under the new ACFI system this type of leave will be removed due to its lack of relevance and low intake.

The government wants to encourage providers to improve their process of assessment. This is why the secretary is currently able to suspend providers from appraising residents for funding purposes if they repeatedly fail to conduct their appraisals in the appropriate manner. The problem with this provision is that it locks qualified providers out of our system when we cannot afford to do so. These amendments will allow the secretary to stay any suspension of a provider, subject to meeting certain obligations. It means that providers will stay in our system while at the same time being required to improve their internal assessment processors. This amendment allows the secretary greater flexibility to encourage providers to conduct appraisals and reappraisals properly to avoid suspension coming into effect.

Overall, the ACFI has been designed to streamline the current classification system for the delivery of aged care. Amendment trials have been a success. They were trialled in 2005 with a 23 per cent participation rate. The results were very positive, and most residential centres reported time saving under these provisions. There was a greater level of agreement between the providers’ assessments of residents and those of external assessors. The government has provided an additional $393.5 million over four years to assist homes with the change to the ACFI system and, judging by the results of the previous trials and my own assessment of these amendments, it will be money very well spent.

In these provisions we have sensible changes. Instead of the constant reassessment of those in nursing homes, once their classification has been achieved it will stay in place—except for those who come out of hospitals, who will need to be assessed after six months. It is sensible, it is appropriate, it will stop the unnecessary administration and it will ensure that nursing homes spend their time on what they are paid to do and what we want them to do, which is looking after our aged-care recipients, instead of on unnecessary administration and form filling. This bill is certainly long overdue, and I commend it to the House.

Debate (on motion by Mr Georganas) adjourned.